Individual
WESLEY WILLIAM WICKWAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT FAAOMPT
Contact information
Practice address
1800 PALACE DIRVE, SUITE C, GARDEN CITY, KS 67846
(620) 271-0700
(620) 271-0703
Mailing address
304 TYLER DR, HOLCOMB, KS 67851-9752
(620) 277-0041
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1103245
KS
Other
Enumeration date
09/15/2006
Last updated
06/05/2008
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